Abstract

Background

Pancreatic cancer (PC) – the most serious oncological disease with a unfavorable prognosis. Every year in the world recorded more than 230000 primary patients, 98% of them die. Over the past 5 years, the incidence of pancreatic cancer has increased by 4.2% in men and 12.1% in women. Radical operation in patients with PC is possible to perform only 25% of cases. Among operated patients 5-year overall survival was 20%, and for locally advanced PC (LAPC) 5-year overall survival rate was 8.7%. One of the areas will improve the treatment of LAPC was the use of chemotherapy triplets in combination with stereotactic body radiotherapy (SBRT).

Methods

During the period 2014-2016 in NN Blokhin CRC 48 patients with LAPC were treated with 6 courses of FOLFIRINOX and SBRT (dose per fraction 7.5 Gy, total dose 37.5 Gy). Among these patients was 32 male and 16 female. Most commonly patients complain of pain in the epigastric area intractable narcotic analgesics. In this study was evaluated toxicity by chemotherapy, objective response rate and quality of life.

Results

80% of patients had a hematologic toxicity I grade, 2 patients had a III grade. For all patients was conducted computed tomography, ultrasound after SBRT. After treatment pain disappeared in 23 patients and 11 patients had a decrease in pain intensity. The most common side effect after irradiation was a diarrhea I grade. Objective response rate was 70% after treatment.

Conclusions

Combined chemoradiotherapy including FOLFIRINOX and SBRT is an effective, well-tolerated in patients with LAPC.